When a new determination is created, a comparison is done by the system to see if payments have been processed based on the previous, now superseded decision information. This comparison can result in an over or under payment. When a reassessment results in new decisions, the system automatically compares the new decisions to any existing decisions that have been processed into payments or bills. If the processed amounts are different to the eligibility and entitlement amounts in the new decisions, an over or under payment is created. An overpayment occurs when too much has been paid out on the case. An underpayment occurs when too little has been paid out on the case.
Although new determinations can be created when a case is in a status of "active", "suspended", or "pending closure", over and under payments are not created for a case that has been suspended. Additionally, an agency can prevent new determinations and over and under payments from being created within closed cases by setting an application property as part of administration. For cases that include suspended payments, an over or under payment will still be created when a new determination is created, if necessary. This is due to the fact that the over or under payment may be related to several payments that were made over a period of time, of which some may not be suspended and are therefore valid. Also, the expectation is that agencies will deal with the situation in which a payment has been suspended in a timely manner; otherwise the client will not get paid. If the agency is not in a position to act on a suspended payment quickly or they do not want to create over or under payments on cases with suspended payments, they could choose to suspend the case itself.
Case workers can view information in the case about the over or underpayments in order to understand what components were involved. For example, a case worker can view information about an overpayment of $200 and see that the overpayment resulted from an overpayment of $150 for Component A and an overpayment of $50 for Component B. Additionally, the two decisions that resulted in the over or underpayment can be compared. For more information on comparing two decisions, see Comparing Decisions.
Three case types are provided to allow the agency to manage and correct over or underpayments detected during case reassessment: the payment correction case type, the overpayment case type, and the underpayment case type. An overpayment case type is used to correct overpayments only. An underpayment case type is used to correct underpayments only. A payment correction case type can be used to correct either an over or underpayment on a case and unlike the overpayment case and underpayment case types allows case workers to see the over and underpayment amounts broken down by case component for a nominee. For example, a case worker can view a breakdown of an overpayment of $400 that is made up of an overpayment of $500 for Component A and an underpayment of $100 for Component B. An agency can configure whether or not a payment correction case should be used as part of application administration. For more information, see the Cúram Integrated Case Management Configuration Guide.
An agency may choose to prevent the creation of over or underpayments as a result of the reassessment of a case. For example, if the creation of an overpayment in one case needs to be held for a period of time while a caseworker continues to manage evidence changes for other cases that use the same evidence. Note that development effort is required in order to do this. For more information, see the Inside Cúram Eligibility and Entitlement Using Cúram Express Rules developers guide.